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Work-fl ow Management

Automated referrals close the communications loop

Boston Medical Center streamlines work fl ow and interoperability – and sees a huge return on investment – using Carefx eReferral portal.

By Joel Vengco T

he primary care physician (PCP) refers a patient to a specialist; the specialist treats the patient and then sends the patient and a report back to the PCP. It’s a simple process, but for most organizations it actually comprises a number of steps that make for a complex work flow for facilities, clinicians and patients.

Because of this complex and manual system, pa- tients were often not receiving timely care, the hos- pital was not achieving optimal patient volume and simplified work flow, revenues were not where they could and should be and physicians were frustrated. After looking at our own paper-based referral process in the fall of 2009, Boston Medical Center (a private, not-for-profit, 626-bed academic medical center) and its neighboring 15 community health centers (CHCs) recognized the need for the automa- tion of referrals and the ex- change of information and collaboration to benefit patient care throughout our system. We decided to integrate an electronic

Joel L. Vengco is the director and chief applications offi cer at Boston Medical Center. For more on Carefx solutions:

referral management solution into our community information exchange (CIE), where simplified work flow, interoperability, service and usability could flourish.

Manual system multiplies complexity With the current, complex referral process, many times our patients would receive less-than-optimal care, and clinicians would grow increasingly frustrated over the lack of complete and timely information. Also, an enormous amount of revenue was lost due to missed appointments and inefficient work-flow procedures. Prior to the use of an electronic referral manage- ment solution, BMC, like most other hospitals and networks across the country, used a manual, cum-

18 August 2010

With an electronic referral management solution, BMC has been able to simplify and optimize the referral process, enhance collaboration among community providers, improve patient access to care and coordinate that care effi ciently.

bersome system to process referrals from within referring providers, and much of it was dependent on fax machines or phone calls. The limitations were enormous, with the process being difficult, inefficient and confusing for both clinicians and patients. Being awarded a 12-month federal grant for inno- vative technology development and implementation from the Health Resources and Services Administra- tion’s (HRSA) High Impact HIT Innovations Grant Program, we were given the opportunity to conduct a search for a vendor that could assist us with auto- mating our referral process. We considered multiple vendors based on health information exchange (HIE) experience, vision, innovation, focus and track re- cord. After evaluation, BMC selected Carefx, an interop- erable work-flow solution provider whose solutions aligned with our core strategies and our need to im- prove work flow and close the communication loop in referrals. Our non-automated referral process often left clinicians with inadequate patient information, minimal feedback and insufficient tracking abilities. In just eight months, Carefx was able to develop a referring physician dashboard on our CIE framework to address the inefficient referral process. With an electronic referral management solution,


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